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Started by bacardiandlime, January 30, 2020, 03:20:28 PM

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AmLitHist

WRT vaccines:  our oldest was of the age to get the first chickenpox vaccine when it came out.  I asked her pediatrician to give it to her, and he convinced me not to, not least because he had kids the same age as ours and wasn't letting them get it.  As he said, we know what chickenpox is, having both had bad cases ourselves when we were young, plus all the years and years of experience and observation by the medical community.  But he argued that not only did we not know all the side effects of the vaccine (even after extensive and non-rushed testing of it), we weren't even sure it would work (and anecdotally, a lot of kids in that kindergarten class had gotten the vaccine and still got bad cases of chickenpox in later years). 

Of course, COVID isn't the same thing, and nobody's awaiting an effective and safe vaccine more than I*, but just as a layman with a dusty biology BA and some common sense, I don't trust that this (first, rushed-to-the-market) one is going to be either.  Add to that the politics on all sides, plus the various unholy alliances of money, politics, and pharmaceutical companies, and . . . . nope.
--
*I've tried to be rational and have common sense throughout, although I will say I was worried back in, what, January?, when the first reports from China were in small print buried in the news.  However, the French report in late May saying that 1 in 10 diabetics admitted with COVID dies within 7 days scares me half to death. (And yes, I'm boiling that down to the scariest parts, but it does scare me.  Besides, Murphy's Law, plus my health issues of the past couple of years. . . . )

Stockmann

I'm generally very pro-vax, and you bet my kid is up to date with immunizations, but it's one thing when dealing with well-established vaccines for which we have plenty of real-world evidence on efficacy and safety (and a long history of improving the vaccine's safety and efficacy), but quite another when dealing with a new, highly rushed vaccine for a new disease. It's hard to imagine corners will not be cut given the huge potential market, political pressures to have an exit strategy and the promise of global media glory for whoever develops it first. The combo of little international cooperation in fighting covid and the WHO's failures and politicization mean that there will be little in the way of effective international oversight over anyone who claims to have a safe, effective vaccine. So I wouldn't give it to my child. If you're diabetic and in a nursing home in a hotspot, it makes sense to take your chances with a vaccine, but for a lot of people it won't. Which unfortunately means that even if the vaccine is safe and effective you won't have anything approaching herd immunity, because we're not the only ones who think that.
I kind of hope an effective treatment is developed first. The risk-benefit analysis would be pretty different than for a vaccine, and it would be an effective exit strategy, at least if combined with test-and-trace.

Caracal

Quote from: AmLitHist on July 07, 2020, 07:29:41 AM
WRT vaccines:  our oldest was of the age to get the first chickenpox vaccine when it came out.  I asked her pediatrician to give it to her, and he convinced me not to, not least because he had kids the same age as ours and wasn't letting them get it.  As he said, we know what chickenpox is, having both had bad cases ourselves when we were young, plus all the years and years of experience and observation by the medical community.  But he argued that not only did we not know all the side effects of the vaccine (even after extensive and non-rushed testing of it), we weren't even sure it would work (and anecdotally, a lot of kids in that kindergarten class had gotten the vaccine and still got bad cases of chickenpox in later years). 

Of course, COVID isn't the same thing, and nobody's awaiting an effective and safe vaccine more than I*, but just as a layman with a dusty biology BA and some common sense, I don't trust that this (first, rushed-to-the-market) one is going to be either.  Add to that the politics on all sides, plus the various unholy alliances of money, politics, and pharmaceutical companies, and . . . . nope.
--
*I've tried to be rational and have common sense throughout, although I will say I was worried back in, what, January?, when the first reports from China were in small print buried in the news.  However, the French report in late May saying that 1 in 10 diabetics admitted with COVID dies within 7 days scares me half to death. (And yes, I'm boiling that down to the scariest parts, but it does scare me.  Besides, Murphy's Law, plus my health issues of the past couple of years. . . . )

For those who don't plan on taking a vaccine, I'm betting you won't be able to keep your job without one. If there is an effective way to prevent Covid infections, who would want to allow someone to spread it at colleges to people who might have immune conditions preventing them from getting a vaccine?

Your concerns are also not well founded. The vaccines are obviously being developed quickly, but they are being developed with trials and testing. Before any vaccine is going to go to market, it has to go through multiple stages of trials. They first test them on a small number of people to make sure there aren't any obvious side effects and that they produce antibodies, they then scale up to a few hundred to a thousand to do those on a larger scale, and then they do large scale trials to check both effectiveness at preventing illness and infection, as well as any rarer reactions or dangers.

The testing is why development isn't instantaneous. There already are at least thirty Covid vaccines that have been created. Nobody is getting them outside trials, yet, because you have to make sure they are safe and effective enough first. That's what takes time. I'm sure I will not be first in line for any vaccine, but I'd certainly get it whenever I had the opportunity. I find it kind of stunning that anybody without a condition which would make a vaccine inadvisable wouldn't feel that way.

Caracal

#723
Quote from: Stockmann on July 07, 2020, 08:58:15 AM
I wouldn't give it to my child. If you're diabetic and in a nursing home in a hotspot, it makes sense to take your chances with a vaccine, but for a lot of people it won't. Which unfortunately means that even if the vaccine is safe and effective you won't have anything approaching herd immunity, because we're not the only ones who think that.


Jesus. I'd hope that the moment it became available, the school my kid attended would require it. I'm not interested in having my kid get infected and transmit the virus to me or family members more vulnerable because others have vague, not very well thought out worries.

ab_grp

Quote from: AmLitHist on July 07, 2020, 07:29:41 AM
WRT vaccines:  our oldest was of the age to get the first chickenpox vaccine when it came out.  I asked her pediatrician to give it to her, and he convinced me not to, not least because he had kids the same age as ours and wasn't letting them get it.  As he said, we know what chickenpox is, having both had bad cases ourselves when we were young, plus all the years and years of experience and observation by the medical community.  But he argued that not only did we not know all the side effects of the vaccine (even after extensive and non-rushed testing of it), we weren't even sure it would work (and anecdotally, a lot of kids in that kindergarten class had gotten the vaccine and still got bad cases of chickenpox in later years). 

Just wanted to add that I had the same experience when my eldest daughter was offered the vaccine.  As you say, this is a different situation, but hopefully there will be solid guidance in this case as well.  I have one daughter in college and one in high school, and I hope there will be an effective vaccine coming.  Daughter who just started her first job as a nurse two weeks ago has already had a somewhat lengthy exposure to a patient who apparently had the virus and had come into contact with many, many folks at the hospital.  I'm sure that's not uncommon, unfortunately.  I am cautiously optimistic, but we'll see.

Caracal

Quote from: AmLitHist on July 07, 2020, 07:29:41 AM
WRT vaccines:  our oldest was of the age to get the first chickenpox vaccine when it came out.  I asked her pediatrician to give it to her, and he convinced me not to, not least because he had kids the same age as ours and wasn't letting them get it.  As he said, we know what chickenpox is, having both had bad cases ourselves when we were young, plus all the years and years of experience and observation by the medical community.  But he argued that not only did we not know all the side effects of the vaccine (even after extensive and non-rushed testing of it), we weren't even sure it would work (and anecdotally, a lot of kids in that kindergarten class had gotten the vaccine and still got bad cases of chickenpox in later years). 

BTW, the Chicken Pox vaccine is very safe and quite effective. Sounds like you had a bad doctor.


ab_grp

Quote from: Caracal on July 07, 2020, 10:16:59 AM
Quote from: AmLitHist on July 07, 2020, 07:29:41 AM
WRT vaccines:  our oldest was of the age to get the first chickenpox vaccine when it came out.  I asked her pediatrician to give it to her, and he convinced me not to, not least because he had kids the same age as ours and wasn't letting them get it.  As he said, we know what chickenpox is, having both had bad cases ourselves when we were young, plus all the years and years of experience and observation by the medical community.  But he argued that not only did we not know all the side effects of the vaccine (even after extensive and non-rushed testing of it), we weren't even sure it would work (and anecdotally, a lot of kids in that kindergarten class had gotten the vaccine and still got bad cases of chickenpox in later years). 

BTW, the Chicken Pox vaccine is very safe and quite effective. Sounds like you had a bad doctor.

AmLitHist and I may be talking about similar time periods, not very recent in my case at least.  I don't think my daughter's doctor was a bad doctor at all.  She just didn't think it was good to give the vaccine at that time.  Out of curiosity, have you never had a doctor that recommended against a vaccine, test, procedure, or treatment even temporarily? I have. 

secundem_artem

I've been sitting in on a series of Covid webinars put on by the American Public Health Association and the National Academies of Medicine.

The level of cooperation studying vaccines is probably better than posters up-thread believe.  And the design of the trials is different as well.  There are dozens of trials underway, and not all of them are using a placebo arm since data sharing among research groups allows the placebo data from a few trials to be generalized more broadly.  There are about 6-8 different types of vaccines being looked at as well and the innovation behind them is much more creative than the usual killed/live attenuated/sub-unit vaccines we are used to seeing. There are also likely to be some very unique trials where healthy, young volunteers receive a vaccine and are then voluntarily infected.  Long story short, this ain't your grandpa's science anymore.

The bigger issue for vaccines is less likely to be safety and efficacy than it is for availability.  The contract to provide 100 million doses means the manufacturer needs to source 100 million vials, 100 million stoppers, 100 million packages, 100 million package inserts.  Best case scenario may be that there will be an available vaccine for emergency use in an outbreak by late 2020 (e.g. ER and ICU staff in a replay of the chaos we saw in NYC).  Availability for the general public is still some ways off - probably mid to late 2021 at the very earliest.
Funeral by funeral, the academy advances

Caracal

Quote from: ab_grp on July 07, 2020, 10:34:02 AM
Quote from: Caracal on July 07, 2020, 10:16:59 AM
Quote from: AmLitHist on July 07, 2020, 07:29:41 AM
WRT vaccines:  our oldest was of the age to get the first chickenpox vaccine when it came out.  I asked her pediatrician to give it to her, and he convinced me not to, not least because he had kids the same age as ours and wasn't letting them get it.  As he said, we know what chickenpox is, having both had bad cases ourselves when we were young, plus all the years and years of experience and observation by the medical community.  But he argued that not only did we not know all the side effects of the vaccine (even after extensive and non-rushed testing of it), we weren't even sure it would work (and anecdotally, a lot of kids in that kindergarten class had gotten the vaccine and still got bad cases of chickenpox in later years). 

BTW, the Chicken Pox vaccine is very safe and quite effective. Sounds like you had a bad doctor.

AmLitHist and I may be talking about similar time periods, not very recent in my case at least.  I don't think my daughter's doctor was a bad doctor at all.  She just didn't think it was good to give the vaccine at that time.  Out of curiosity, have you never had a doctor that recommended against a vaccine, test, procedure, or treatment even temporarily? I have.

To modify slightly, it doesn't sound like it was a very good recommendation, or that the worry was based on much sound science. Doctors make mistakes too.

downer

It's not possible to study the long term effects of a new medication without waiting a long time. I'll wait until the long term effects are known.

There is the question of how much to trust the pharmaceutical industry. Given the history of the last 50 years, I have very little trust in them. That's not to say I don't take any meds -- I do, occasionally. I even get a flu shot most years. Some medication does save lives. But the industry has failed to keep research pure: lots of cases of science being perverted by the demand to make profits. There have been far too many cases of new drugs first being approved and then later withdrawn because of their dangers.

The issue of whether universities can require faculty to have immunizations is not a simple one. There's an interesting link here about it. https://laborandemploymentlawupdate.com/2019/11/12/navigating-the-legal-risks-of-a-mandatory-vaccine-program-for-employees/
"When fascism comes to America, it will be wrapped in the flag and carrying a cross."—Sinclair Lewis

Parasaurolophus

FWIW, almost everyone else in my family is a physician, including both my parents, and they've occasionally advised against certain vaccinations. In one case from a while ago which I only vaguely remember, they were concerned about the adjuvant used and did not think the risks associated with it outweighed the risks associated with the illness. (The adjuvant wasn't aluminum, it was something more unusual, but that's as much as I remember.)
I know it's a genus.

Caracal

Quote from: downer on July 07, 2020, 11:02:07 AM
It's not possible to study the long term effects of a new medication without waiting a long time. I'll wait until the long term effects are known.


That's nice. But are you living in a cave? And do you plan to just remain there for the next five years?

I'll defer to the experts who I'm pretty sure will tell you the same thing, but just because a vaccine is new, doesn't mean we are doing some brand new thing with totally unknown risks. The risks would presumably be similar to those of other vaccines. Vaccines can cause certain kinds of short term reactions, but I've never heard of any long term ones that would only surface years later. A vaccine is not likely to cause higher rates of cancer, or heart disease years down the road because one never has and I don't think there's any real mechanism for that to happen.

downer

Quote from: Caracal on July 07, 2020, 11:21:28 AM
Quote from: downer on July 07, 2020, 11:02:07 AM
It's not possible to study the long term effects of a new medication without waiting a long time. I'll wait until the long term effects are known.


That's nice. But are you living in a cave? And do you plan to just remain there for the next five years?

I'll defer to the experts who I'm pretty sure will tell you the same thing, but just because a vaccine is new, doesn't mean we are doing some brand new thing with totally unknown risks. The risks would presumably be similar to those of other vaccines. Vaccines can cause certain kinds of short term reactions, but I've never heard of any long term ones that would only surface years later. A vaccine is not likely to cause higher rates of cancer, or heart disease years down the road because one never has and I don't think there's any real mechanism for that to happen.

One question about the future is what proportion of the population will get a vaccine if it becomes available. Given the resistance to ones that have been proven safe, I expect that there will be plenty of reluctance in the population, for good and bad reasons, to take the new one.
This news item says only half of Americans would get one. https://www.cbsnews.com/news/coronavirus-vaccine-half-americans-would-get/
So public policy won't be able to assume that everyone is getting the vaccine.
"When fascism comes to America, it will be wrapped in the flag and carrying a cross."—Sinclair Lewis

Caracal

Quote from: Parasaurolophus on July 07, 2020, 11:15:48 AM
FWIW, almost everyone else in my family is a physician, including both my parents, and they've occasionally advised against certain vaccinations. In one case from a while ago which I only vaguely remember, they were concerned about the adjuvant used and did not think the risks associated with it outweighed the risks associated with the illness. (The adjuvant wasn't aluminum, it was something more unusual, but that's as much as I remember.)

I'm not really eager to wade into the medical practice part of this, but in general terms vaccines are incredibly heavily regulated and ones that are approved for broad use are very safe. Obviously, you don't want to vaccinate someone for yellow fever unless they are planning to travel to a place where it is endemic. However, that's what the vaccine schedule is for. The vaccines on there all have very low risk of side effects and are needed.

Caracal

Quote from: downer on July 07, 2020, 11:27:54 AM
Quote from: Caracal on July 07, 2020, 11:21:28 AM
Quote from: downer on July 07, 2020, 11:02:07 AM
It's not possible to study the long term effects of a new medication without waiting a long time. I'll wait until the long term effects are known.


That's nice. But are you living in a cave? And do you plan to just remain there for the next five years?

I'll defer to the experts who I'm pretty sure will tell you the same thing, but just because a vaccine is new, doesn't mean we are doing some brand new thing with totally unknown risks. The risks would presumably be similar to those of other vaccines. Vaccines can cause certain kinds of short term reactions, but I've never heard of any long term ones that would only surface years later. A vaccine is not likely to cause higher rates of cancer, or heart disease years down the road because one never has and I don't think there's any real mechanism for that to happen.

One question about the future is what proportion of the population will get a vaccine if it becomes available. Given the resistance to ones that have been proven safe, I expect that there will be plenty of reluctance in the population, for good and bad reasons, to take the new one.
This news item says only half of Americans would get one. https://www.cbsnews.com/news/coronavirus-vaccine-half-americans-would-get/
So public policy won't be able to assume that everyone is getting the vaccine.

So, what you seem to be saying is that you would, for not very good reasons, refuse to get a vaccine. Then you point out that your refusal to do so, could mean that lots of people remain vulnerable to COVID and can continue to infect people with certain conditions which might make it impossible for them to get a vaccine, and might also put them at much higher risk of dying from Covid?